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Biomedical subjects

K Tabayashi

Publications and source records attributed to K Tabayashi.

At least 181 records · Page 10Linked to original sources
PubMed1990

[Aortic valve replacement in a patient with von Willebrand's disease--a case report].

A 38-year-old man was admitted to our hospital with complaints of palpitation and shortness of breath. On auscultation, presence of severe aortic regurgitation was found. Seven years prior to admission, he had undergone rectal polypectomy complicated by postoperative serious hemorrhage which had led to the diagnosis of von Willebrand's disease. Aortic valve replacement with a Björk-Shiley prosthesis was performed under routine cardio-pulmonary bypass. He received Confact-F as a replacement therapy of factor VIII throughout the perioperative period. His operative and postoperative courses were uneventful without difficulties in hemostasis. The patient was placed on a regimen of anticoagulation (Warfarin sodium) without increase in the bleeding tendency. He is asymptomatic and doing well six months after the operation.

Adult↗
PubMed1990

[A case of major dehiscence of a prosthetic aortic valve].

A case, 48-year-old man, was presented of dehiscence of an aortic Björk-Shiley prosthesis, which was diagnosed by pendular movement of prosthetic mount in cineangiographic finding. Emergent operation of Re-AVR was performed successfully. Valve dehiscence should be confirmed by cineangiographic examination, in case of progressive congestive heart failure combined with traumatic hemolytic anemia and high grade fever suggestive of prosthetic valve endocarditis.

Aortic Valve↗
PubMed1989

[Emergent surgical management of aortic dissecting aneurysm, type A Stanford, complicated with acute cardiac tamponade; report of a case].

A 52-year-old woman, who had been treated medically for 31 days with the diagnosis of type A aortic dissection, suddenly fell in shock because of acute cardiac tamponade. Emergent operation was performed two hours after the onset of shock. Entry and perforation were located in the ascending aorta. Ascending aorta was opened without cross-clamping under profound hypothermic low flow perfusion through femoral artery, and intraluminal grafting with a double ringed graft was completed. Combined technique of open distal anastomosis and ringed graft is useful in such an emergent case as cardiac tamponade of aortic dissection.

Aortic Dissection↗
PubMed1989

[Surgical treatment of tricuspid regurgitation].

The purpose of this study is to compare early and late results of tricuspid valve replacement (TVR), tricuspid annuloplasty (TAP) and non operative management for patients with tricuspid regurgitation (TR). 5 patients underwent TVR and 70 patients received TAP (Kay-Boyd's annuloplasty in 16, Bex reducer method in 40, Carpentier's ring method in 14). 21 patients were managed non-operatively. The following results were obtained. TR should be repaired aggressively, if the regurgitation was more than second degree and tricuspid annulus was above three finger breadth. Judging from the pattern of residual TR after Kay-Boyd's annuloplasty and Bex reducer method, Bex reducer and Carpentier's ring should be placed over the three commissures except the conduction tract.

Heart Valve Prosthesis↗
PubMed1989

[Clinical experience of autotransfusion system (ATS)--changes in free hemoglobin and haptoglobin].

This study was done to evaluate the usefulness of ATS and the administration of haptoglobin, and is comprised of 15 patients following open heart surgery. Shed mediastinal blood was retransfused during 4-6 hours after open heart surgery. Plasma free Hb (F-Hb) value of the shed blood was 647 mg/dl. But plasma F-Hb of patient did not significantly increase after retransfusion of shed blood without administration of haptoglobin. Plasma F-Hb of patient decreased significantly from 12 mg/dl to 3.3 mg/dl when haptoglobin was given. (p less than 0.05). There was no serious complication associated with the use of ATS, and could save 300 ml of homologous blood. It is concluded that ATS can be used safely for saving homologous blood after open heart surgery and haptoglobin is effective for decreasing of plasma F-Hb.

Blood Transfusion, Autologous↗
PubMed1989

[Improvement of operative result of Stanford type A aortic dissection].

21 cases of Stanford type A aortic dissection (15 acute and 6 chronic) were treated with or without surgery in the last 38 months. Out of seven cases who were admitted before October, 1986, three cases were treated medically and all died suddenly within 30 days. The remaining four cases were operated upon as emergency with only one survival. Extensive hemorrhage was the cause of operative deaths. After November 1986, substantial reduction in hospital mortality (one death in eight acute cases) was accomplished by the following strategy for acute aortic dissection, i.e., (1) urgent operative intervention for cases with cardiac involvement, and initial medical treatment followed by elective operation at chronic stage for those without cardiac involvement, (2) routine use of open distal anastomosis, (3) preferential adoption of simple surgical intervention limited to the ascending aorta. There was no operative death in six chronic cases in spite of more extensive approach. These results suggest that the strategy mentioned above is reasonable in treatment for Stanford type A dissecting aneurysm.

Adult↗
PubMed1989

[A clinical study of the myocardial protective effect of allopurinol].

This study was proposed to study the myocardial protective effect of allopurinol clinically. This study involved 65 patients undergone coronary artery bypass operations or cardiac valve replacements or plasties. Patients were divided into two groups: group I, 30 patients received 2,400 mg of allopurinol preoperatively; group II, 35 patients undergoing no treatment of allopurinol. Postoperative values of GOT, CK-MB and LDH1 + LDH2 in group I were significantly lower than that of group II. These results suggest that allopurinol has advantageous effect on myocardial protection.

Adult↗
PubMed1989

[Surgical experience in patients with Marfan's syndrome and cardiovascular disease].

10 patients with Marfan's syndrome and cardiovascular disease were operated at Tohoku University Hospital from 1971 to 1988. Surgery included composite valve graft replacement of ascending aortic aneurysm with aortic regurgitation in 5 patients and prosthetic mitral valve replacement in three patients; two had resection of aneurysm with Dacron tube replacement. Operative mortality was 10%. Two late death occurred (22%). It was suggested that regular follow-up examination is important in these patients to detect new lesions and to evaluate known lesion.

Adolescent↗
PubMed1989

[Effects of exocorpol and haptoglobin on hemolysis during ECC].

This study was performed to evaluate the effects of Exocorpol and Haptoglobin on hemolysis during ECC. We measured free hemoglobin (F-Hb) and free haptoglobin (F-Hp) at pre- and post-ECC. Patients were divided four groups: Group C, 5 patients undergoing no treatment; Group Ex, 5 patients undergoing treatment of Exocorpol; Group Hp, 5 patients undergoing treatment of Haptoglobin; Group Ex + Hp, 5 patients undergoing treatment of Exocorpol and Haptoglobin. F-Hb of pre- and post-ECC in four groups were 0 mg/dl: 85 mg/dl (Group C, p < 0.01), 0 mg/dl: 2 mg/dl (Group Ex, NS), 0 mg/dl: 1 mg/dl (Group Hp, NS), 0 mg/dl: 0 mg/dl (group Ex + Hp, NS). F-Hp of pre- and post-ECC in four groups were 143 mg/dl: 9 mg/dl (Group C, p < 0.02), 133 mg/dl: 25 mg/dl (Group Ex, p < 0.05), 186 mg/dl: 195 mg/dl (Group Hp, NS), 66 mg/dl: 163 mg/dl (Group EX + Hp, p < 0.05). There was no significant difference in F-Hb and F-Hp of pre-ECC among four groups. F-Hb of post-ECC in Group C was significantly higher than that of Group Ex, Hp and Ex + Hp (p < 0.01), and F-Hp of post-ECC in Group Hp and Ex + Hp was significantly higher than that of Group C and Ex.(p < 0.01, p < 0.02). We concluded that Exocorpol and Haptoglobin were effective on hemolysis during ECC, and combination of these was more effective.

Extracorporeal Circulation↗
PubMed1989

[Clinical effects of denopamine in patients with cardiac operations].

Denopamine is a new, orally active, positive inotropic agent. We evaluated its clinical effects in 13 patients who had undergone cardiac operations, 8 were in early postoperative periods and 5 were in late postoperative periods. In the former, denopamine therapy (30 mg/day) were started on the 6-14 th postoperative day in 5 patients so that they might free from catecholamine drip infusion (2-14 micrograms/kg/min), and on the 14-24th postoperative day in 3 patients in order that pleural effusion might reduce. All 5 patients were weaned from catecholamine, and pleural effusion in 3 patients disappeared completely. In the latter, denopamine therapy were indicated so that they might get relief from the symptoms of chronic heart failure. Although they had undergone combined valvular operations, they still remained in NYHA class II or III postoperatively, associated with cardiomegaly, hepatomegaly and atrial fibrillation. Denopamine therapy (15-30 mg/day) were quite effective in improving subjective symptoms but not in reducing cardiomegaly or hepatomegaly. No clinically significant side effects were noticed during 9-14 months of denopamine therapy. We conclude that denopamine is a quite useful cardiotonic agent in the postoperative management of patients with cardiac surgery.

Adult↗
PubMed1988

Assessment of left ventricular function in patients with mitral regurgitation: value of the forward ejection fraction.

This study was aimed at assessing the value of preoperative forward ejection fraction (FEF) and corrected forward ejection fraction (CFEF) as an index of postoperative myocardial function. Utilizing 34 patients with mitral regurgitation, usefulness of the preoperative FEF and CFEF was evaluated with special reference to incidence of postoperative low output syndrome (LOS) and improvement in the New York Heart Association (NYHA) classification, comparing other indices of left ventricular function such as cardiac index (CI), stroke index (SI), left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI). There was a significant correlation between FEF and CI, SI, LVEDVI or LVESVI, and between CFEF and CI, SI, LVEDVI or LVESVI. The FEF and CFEF, however, were better indicators for predicting the occurrence of postoperative LOS than EF. Postoperative improvements in the NYHA classification were parallel to that of the FEF and CFEF changes, but did not coincide with that of the EF. Based on these findings, it is concluded that FEF and CFEF are more useful indicators than EF for evaluation of left ventricular myocardial performance in patients with mitral regurgitation.

Adult↗
PubMed1988

Cardiac transplantation without cardiopulmonary bypass: experimental model to study growth of the transplanted heart.

An experimental model using surface-induced (20 degrees C) deep hypothermia and total circulatory arrest instead of cardiopulmonary bypass was developed for the study of growth of the transplanted heart. Autotransplantation of the heart was performed in 42 young dogs weighing from 4.4 to 9.0 kg (mean, 6.9 kg). Time of ischemia ranged from 26.0 to 60 minutes (mean, 43.4 minutes). Return of satisfactory cardiac function occurred in all but one animal. An early high mortality rate was due primarily to pulmonary complications, but with modifications to the technique, long-term survival increased to 70%. Early deaths (5 days to 13 weeks) of five dogs during preliminary trials were due to pleural effusion (2), sepsis (1), endocarditis (1), and ascites (1). There have been 14 long-term survivors (range, 194 to 498 days; mean, 264 days). Long-term survivors appear well, are active, and show satisfactory growth. This experimental model eliminates the need for heparinization and reduces the potential for complications associated with cardiopulmonary bypass in the dog. It avoids cannulations that might impinge on anastomotic sites. This model appears to be suited for studying growth of the transplanted heart.

Animals↗
PubMed1988

Ischemic myocardial protection. Comparison of nonoxygenated crystalloid, oxygenated crystalloid, and oxygenated fluorocarbon cardioplegic solutions.

This study was designed to compare myocardial protection with a nonoxygenated crystalloid solution, an oxygenated crystalloid solution, and an oxygenated fluorocarbon cardioplegic solution. Postischemic ventricular performance was studied in three equal (N = 7) groups of dogs subjected to 120 minutes of global ischemia induced at an average myocardial temperature of 18.5 degrees +/- 1.4 degrees C (range 17.0 degrees to 21.0 degrees C). Left ventricular global and regional function was evaluated by sonomicrometry and micromanometers before ischemia and at 45 and 60 minutes after ischemia. Stroke volume index, left ventricular pressure-minor external diameter loop area, percent shortening, first derivative of left ventricular pressure, mean velocity of circumferential fiber shortening, and the slope of the end-systolic pressure were used to evaluate myocardial contractility. In vitro oxygen content of the three cardioplegic solutions was measured at a mean injection temperature of 8.3 degrees +/- 0.6 degrees C: 0.8 +/- 0.1 vol% (nonoxygenated crystalloid cardioplegia), 3.2 +/- 0.2 vol% (oxygenated crystalloid cardioplegia), and 6.2 +/- 0.2 vol% (oxygenated fluorocarbon cardioplegia). Recovery of global and regional function was significantly (p less than 0.05) better with both oxygenated solutions than with the nonoxygenated solution. Differences between the oxygenated crystalloid and fluorocarbon groups were not significant. We conclude: (1) Compared to nonoxygenated crystalloid cardioplegia, oxygenated crystalloid and oxygenated fluorocarbon cardioplegic solutions gave superior myocardial protection during 2 hours of ischemic arrest; (2) no difference was found in protective effects between an oxygenated crystalloid and an oxygenated fluorocarbon solution.

Animals↗